What Really Happens Inside Your Head When You Have a Concussion?
A new study shows that how your brain shakes, rattles, or rolls after you're hit in the head may determine whether or not you suffer a concussion.
By Stacey Colino
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It’s widely known that a hard hit to the head can give you a concussion. But what happens in the brain after the impact has been a bit of a mystery. A study published in March 2019 in Physical Review Letterssuggests that the biomechanics may be even more nuanced than previously believed.
To gain a better understanding of the biomechanics of the brain during and after a blow to the head, a team of researchers gathered data from Stanford University football players who experienced impacts to the head while wearing helmets with special mouth guards that recorded how their heads moved after an impact, as well as data from NFL players. Then the researchers loaded this data into a computer model of the brain and used the computer to simulate 189 collisions to try to figure out what happens in the brain that leads to a concussion.
They found that the differences between impacts that led to concussions and those that didn’t had to do with how and where the brain shakes after the impact.
“The main finding is that impacts that led to concussion showed completely different movement patterns,” explains the study's co–lead author Mehmet Kurt, PhD, an assistant professor of mechanical engineering at the Stevens Institute of Technology in Hoboken, New Jersey. “When you get a hit to the head, the brain oscillates at a certain frequency [30 Hz, which is about 30 times a second] inside the skull. It’s like when you hit a plate of Jello: You get ripples and small oscillations inside.”
When a concussion occurs, Dr. Kurt explains, “instead of areas of the brain moving largely in unison, deep white matter within the brain, especially the corpus callosum — a part of the brain that connects the left and right hemispheres — oscillates at a faster rate than surrounding areas, placing significant strain on those tissues.”
In other words, he says, some blows to the head “make white matter jiggle in a particular fashion, and some don’t.” The researchers’ observations jibe with clinical observations — people who experience concussions often have damage to the corpus callosum.
The researchers say their findings need to be tested more extensively to clarify what kinds of head impacts are more likely to lead to concussions and other mild traumatic brain injuries. (This study didn’t investigate whether the location or direction of the impact affects the brain’s motion.)
But the hope is that “by understanding the characteristics and patterns of these strains, we can design better helmets and protective equipment in the future,” says co–lead author Kaveh Laksari, PhD, an assistant professor of biomedical engineering at the University of Arizona in Tucson. The ultimate goal is to develop a helmet that could “prevent these dangerous dynamics from emerging in the brain” after impact, adds Kurt.
These findings might be used to develop technologies that could diagnose a concussion on-site in real time — on the sidelines at a football or soccer game, for example — which could potentially improve treatment and outcomes for those who experience a nasty head injury.
“Concussion is hard to diagnose — there’s no universal grounds for how to diagnose one,” notes Kurt, who is also an adjunct assistant professor at the Translational and Molecular Imaging Institute at the Icahn School of Medicine in New York City. Developing a diagnostic tool to measure movement patterns in specific areas of the brain after a hard impact to the head might make a significant difference.
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